Skilled Nursing Facility (SNF) / Resource Utilization Group (RUG) Auditor III, Healthcare
About The Position
In this fully remote position as a Skilled Nursing Facility auditor you will apply your expert clinical knowledge to validate the accuracy of billed charges to ensure the integrity of the paid claim including coding validation, payment accuracy, contractual requirements and compliance with regulations. You will utilize industry and EXL proprietary tools in the review process, and will write professional communications documenting audit findings and supporting rationales. You will also apply your extensive clinical and industry knowledge to identify audit trends and opportunities.
Requirements
- Expert clinical knowledge
- Skilled Nursing Facility (SNF) auditing experience
- Resource Utilization Group (RUG) auditing experience
- Proficiency in coding validation
- Understanding of payment accuracy
- Knowledge of contractual requirements
- Familiarity with compliance regulations
- Ability to use industry and EXL proprietary tools
- Strong professional communication skills for documenting audit findings
- Ability to identify audit trends and opportunities
Nice To Haves
- A brief coding/auditing assessment may be included as part of the interview process.
Responsibilities
- Apply expert clinical knowledge to validate the accuracy of billed charges.
- Ensure the integrity of the paid claim, including coding validation, payment accuracy, contractual requirements, and compliance with regulations.
- Utilize industry and EXL proprietary tools in the review process.
- Write professional communications documenting audit findings and supporting rationales.
- Apply extensive clinical and industry knowledge to identify audit trends and opportunities.
Benefits
- For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
